The public inquiry into the Welsh Ambulance Service is the culmination of more than a decade of problems which have regularly surfaced within this vital NHS service.

The inquiry, which has received little support from staff, will focus on the running of the service, its financial problems, poor equipment and failure to meet 999-call response targets.

The outcome, after four months of deliberations, is almost certain to pinpoint extra cash as key to paving the way forward.

Managers say they are being forced to make £10m worth of cuts this year but need an extra £35m invested to improve service.

Recently, outgoing chief executive Roger Thayne claimed 500 lives a year were being lost because of poor response to 999 calls. Although the management disputes this, it admits facing major problems.

Almost everyone from the top brass to paramedics agrees a lack of investment, is the root cause.

And perhaps it's ironic that this is one of the few things staff and managers do agree on. Traditionally they have been at constant loggerheads.

David Galligan, a senior officer with Unison, has seen the events unfold over the decade.

'There are many problem areas but they all come back to a lack of investment in the service.

'In an ideal world there would be an ambulance on every street corner to deal with an emergency but that isn't going to happen and the public should be aware of that.

'GPs should also be more aware when they ring for an ambulance for a patient as to whether it's necessary.'

Even before the Welsh Ambulance Service was set up in 1998 there was a history of ill-feeling and a them-and-us atmosphere in the running of the service.

In South Wales this was felt most deeply when the South and East Wales Ambulance Trust was created four years earlier.

This was a merger of the old country ambulance services of South Glamorgan, Gwent and Powys.

It was a strange combination that was soon in dire financial trouble - so much so that the chief executive was unceremoniously sacked on the spot and the Welsh Office declared the trust had failed - an unprecedented step.

Even then ambulance staff complained of sub-standard equipment and poor vehicles. There were serious concerns that the response times to 999 patients in some rural areas were poor - and patients had died as a result.

When all five Welsh ambulance trusts were merged into one - in just six weeks - it was criticised.

Unions agreed the service needed reorganisation but the speed was bound to cause problems.

One of the strangest elements was the creation of the service headquarters in the isolated north Wales town of St Asaph when two thirds of the population were in South East Wales.

Those problems reared their heads again with claims that years of under -funding have accumulated into a major cash crisis.

It has left this vital service with sub-standard equipment, poor response times, low morale and, crucially, workers who in some cases are owed more than £7,000 in back pay.

When overtime shifts were recently cut it made staff morale even lowers.

Any inquiry is unlikely to mend these wounds which have festered for more than a decade.

A major cash injection may go a long way to improving the running of this service but it will take more to build improved staff and management relations.